National Health Policy 2019_DoHS Annual Report_Public Health Update.pdf

National Health Policy 2019_DoHS Annual Report_Public Health Update.pdf

• 1.
  DoHS, Annual Report2075/76 (2018/19) x x a a a t i National Health Policy, 2019 1. Background t a a ta i a i a t a a a am t ig t it i t t a m t a g a t m it i t i i it t tat t t a a it a t i a i a t t a m a t m i a a a t i a m at t a i t i t i a t a a tat a a a t t t i i a g amm t m t a t i t a a mmitm t ma a at i t m a t m a g a ai a a i i t a t t 2. Review it t ta i m t i g a a a ai a a a i t t t t i t atm t t m a i i at i a t a m t m m i a t m ta t i a it t ta i m t Bi ita i a m t i t a t t ga it t ta t i i a i g i t a g t m a t a a i t i a t a g t m a t a i t i a a g i t a t a i a t a a a t i a i t t i i a t t i a t i i ag m t mmi a t t i a a a t t a a a mi i t a it a ima a t t i a t a t ta i i t a ima a t i t t i ag i a m t t t a m t a a i a i m t i at t t i t i t a t t imi a t a a a t i t a i at a i a t i i i it t i it t i t im t a B g it t t a a ima a t a ma ta i t g a am aig ima a t i a i t i i m m t a a t tai a m t a i t a a mmitm t a t i t t t m t a a i a a t t m imi a a it mmitm t t t g a am aig a i g a t a it ima a t a i t a ima a t a t at t a i ta a a a ta i t t i t a i m t ma ta 3. Current Situation a a tat g m t a a ta t i i g ia i i i g a t i a t im m ta a i m i a t g t t a g m t a a t ima a t a t g t t t a t a t a t a it i t a i i t i t i t i t i a ma t a i t a t im t i a it a t ta t t i at t ita a t at i a a a a t i a a a i m it i g a g a g t m ma i a m t a a t a a i g it i t t it t i tm t i a i at t t i agai a a it a m t a g a i t ma i t a t a a it a t i t g i t t i
• 2.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i i g i i t a i t i i t t i m a a im t g it i a t t i a g at a i a m it t i t i a ma ag m t g imi a m ia i t atm t a i i a g t a t i g t i ga t a a t a g a a a ta i i a t a a a t i i a m t a a i m t g i iag a a at i t t atm t i g t a i a t a i mat a a t ta a t a ma a a i at imi a t ma a t m i t a t a a a a a a ia i ma a ia t i m a i g g i t ia a a a i ia a i at i t i a i g t a t m i it i a i g i a t a i t ma m a tai t im mat a a t i a a t a g at i i a i i g i a ma i a t i a i i i a i a a a a t a i a a i i g a it a g a g ma a t i a a t a t i a t g at i a ma t m m it t i a i i a a a ta a t a t a t atm t i it i a t ma i a ta t t a a a a t i t ita a a t i a a mi i a t m a ma t i it i a t ma a t i it g t i ag i a i t a a ga i a t a a t a i t imi a it i a t a at a i at it ag i t t a g at i m ta a ai at i a i t i i t a g i a t a a i g i i a i a t i im a t a it t m t t t t m it a g at t t ag i t a g ai a ma g ma a t 4. Problems, Challenges and Opportunities 4.1. Problems ai m i m g a a ai i g a it a t i at a i i a i it t i t t a t a it a t i a t t i a i it t i a ma a ta t i a t a i at t m i tm t i t a t i a ai a i it a m i m t a ia i t i i a t i t a a t m at t mm i a a mm i a i a ma t i a i t a i a t a i a i t mm i a i a a m ta a t m g at m g a i a a a g i a it a i t t m i im a a t t a ma i a t i ma ita ia a t m t mm m i a i it a at a i a t i a i t i i a mi ia i ta t i a iat a i a a i mat a m ta it a a a at t i i m t a t i i ag a m ag a a a a a t i it a g a t i at t i mm it a t i
• 3.
  DoHS, Annual Report2075/76 (2018/19) ii a a a t i 4.2. Challenges a g i a t t i i g a a a i t a a t t i i g a it a i a t i t g a a i i g a t i it i it t t a a a i i g t i g ig t t it a t a i g t i a ia ta i i g a a g a t i t i i it t a t m im m g a t i a i ma i g t a t t i t a ma a t t a mi g it m t i ta t i i ta ma agi g i ma it a i i a t i a ia i i it i t a t t mi g ia t g i g a t m a iat it imat a g a i a a a g i i t ma agi g a g a g m i i a m i a t i a i g t ata i m it i g a a i i ma i g a i i ma i g ma i g t a t ma ag m t i ma t m m i t g at a t g i t a t a i g a t m t t a at a a g a t m a t mai tai g g a i a a t a t i t m a mi g a it a t i a g a 4.3. Opportunities i g t i i a t t i a i g i i i i a t i am g t a tat a a a t t im m ta a t i a t g i i a a a a t g amm tat a a g m t i a i t a ai a i it i ma t gi g a i m t m t i a t t a i a i i a a a i a t t t t mm it t t a t i i a g amm ma ag m t a a it ta i i ma i g a i i ma i g a i i a a t i a t g m t 5. Relevance, Guiding Principles, Vision, Mission, Goal and Objectives 5.1. Relevance t a i g m a a g a t t t a ig t i t a it a t i it i a t t am i g a t i t at gi a g amm a m at a a a a t i i a a it t a t t t i i i a t i g a t i a t tai t i a i m t a a t g i t m t a a i a t i i a t t a t a t t gi ma at a i i i i i i a im a t a t a a a i t a a mmitm t ma a a t a i t tai a m t a i a g a i g t a i m t i i m m t a 5.2. Guiding Principles t t a ig t i t a t i t g a a a t t m a t i a a t a it a t i t i i a m at t a i t i g g i i g i i a i a a t a ai a i it t a a a m i i a it a t i
• 4.
  DoHS, Annual Report2075/76 (2018/19) iii a a a t i t a i m t a a a a t i i a t t m i a a it t a t t ia a t i ta g t t t a ma gi a i a it a i ig mm i a t g a a a a a at a ia i tm t i i a ita a t i a t t i g i t a t i g a t a m t a i a a a a i a i i i a i m t a a a t i i a t i i 5.3. Vision a t a t a i i i t t a i 5.4. Mission t am ta a t ig t i t g m m a a a a a t i 5.5. Goal a a a a t t m a i i t a t t a ia a g g a a a t a i a a it a t i 5.6. Objectives at t i a i t t i t a ig t t a t a a im a t a t t m a t a t t im t a it a t i i a t i t a a t a a t t i t gt ia a t t t m i t g a g t m t ma gi a i m t m t a a t i a a a t g m ta g m ta a i at t a t m t mm it i m t a t a m t a t t m t i ta t i i ta 6. Policies a i a t i a m a t i t a a i ia i i a ma a i a i t g a t i a t a i m g a t i a a i a t t m a t t im a a at a tat a a a t a t t
• 5.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i a a it t t i a a t ag m a a a i ita a a ia i a a a i a i t g at ma a a a a t i am g g m ta g m ta a i at t a m t ma ag a g at i t a t t a i at i t a a t a i tm t i a t a i a a a ag a t t a at at ga a m at a a a i a i t g at a t ma a t i a i a a ita i a t ma a a a a i g t t i a t g a a a t t ma agi g a t i t t a t i a i a a a im t ma a t i i i i i a a i t a ta a a ita m a it g a t gi a a t mat ia a m t a t i a a i a a t g g a a ma ag m t i t t ag a i t i t g at a a m a a a t t m at mm i a i a i t a a ima i a m at it imat a g t i a i mi a i a t i i a ami i i a ag i a ma i a t mm i a i a a i t g at a t t m a a a t im t i a it a a t at a a m a i ag a m a a t a ita a a t a a a t a a ma i t a a ta a a t i g a a t t a i i m a a i g a a t t m m t a t ma ag m t i ma t m a ma m a ita a t g i a i t g at a t i ma t m a ig t t i ma at t a t a ig t a ia t a t t t atm t a ta a t a a a t at a t i a a a a it a t i i a a t i t i i g ita a
• 6.
  DoHS, Annual Report2075/76 (2018/19) a a a t i g a a im m t a i i at i t a a ma ag ia t t i t a t t t g m am m t a a it t t a t a t i a t i a a m t i a t a a a t a t a i i a a a a a ia a ia a a a g tai a m t t a t t a i a i t a a t a mig a a ma ag a i a t m a iat it m a a m g a i ta a ma ag a a a a t i t m it t i i i a g amm ig i g mi ia i ta a a t i a a a t t a ma ag m t mm i a i a i m ta a ai a at a i a g at a t a a a g m t a ma t t i immig a i a t a t i a t t t a ta i g a a Strategies for each policy Free basic health services shall be ensured from health institutions of all levels as specified Ba i a t i a i a t i t t g m t a a a a g a i a i a t i t t g t a tat a a g m t ma i a i a i t t i a t it a i a i a g m t a i ga a i t a a a g m t a ma tat a a g m t t ma a i a t i Specialized services shall be made easily accessible through health insurance atm t i t at a t i i t a i a t i a t gt a i t g at i t t i a t m Ba t i i ia a i i ta g t g a i it t tat i i a t i a t m ma t a m i g t i t t a t i a t m a mat a i a t a t i a t m a t ia a t i i t tat a g a a
• 7.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i Access to basic emergency health services shall be ensured for all citizens i m g a t i a g a i t g a t i t a i i g a i a t i t a ima ita a a t m a a a a g a g g i a a i t i t mai ig a t a ma i t a i t a ma a a imm iat t atm t i t a t am a it mi im m a i i a a a g a a a am a i it i ta a a i a a m t gi a a a g Air ambulance shall be arranged with specified norms to rescue people from ultra-remote areas with critical health conditions. m g t atm t a a a g a m i i a i i t g i i t ma t a it m g t atm t at a it t i t a a ta a t ai i g t a t a t a gi m i t t ai i g a t t m a t t im a a at a tat a a a t a t t i g t t t a t t a am a t a a t t a ta i i i g a a i a t t i a t i mi t a a a ga a i t a a a g m t a ma t t gt t a t t m i i it t a t t ita a a t i t a t i a ma at t a tat a a a a a i a a it t m g a i i t i g g a i it a a Ba i a t i t a ta i a a t a ima ita a a a ita a i ia ita t tat a ia i ita t a a ta i imi a at a t t a ita a a t i a a m i a tat t a g m t a ta i a a t m m mm it t t ia i i i a im m t t ma t t atm t i m t ma a t a i t a i a m t gi a m i a t t m i i a a a g at a t i a t a m i a i a a t t m a igita i iag i a ma m a t g i a t a a i a t a at a t gt t t i t a a ta a a at a a iag t a ta i i a tat
• 8.
  DoHS, Annual Report2075/76 (2018/19) ii a a a t i t im t a it a t i i a g m ta g m ta mm it a i at a t i t a a t i a t t m t ta a a mi im m i ta a a im m t imi a i ta a g m ta mm it a i at a t i t a a g a a im m t a t i a a t g m ta a g m ta t a mm it a i a a m t a t a i i a i t a a a t a tat a ima ita it i i at a t i a t g t a ai a i it a a at it m a ma ga t a a t ga a i a ga a ai a a ma ag a a i ga i a a a t a tat a ima ita m a t i a t i a a t i i a i i t a ma ag a g at a t m t g a m i t ma a t i a ita a t In accordance with the concept of universal health coverage, promotional, preventive, curative, rehabilitative and palliative services shall be developed and expanded in an integrated manner i i it t t m a t a a t i t a m t t g a t a a g amm i a it t a t a t g amm a a t a a am aig a g a a a t ig a i g t a ai a i it at a t a t i a t m a a i a i a a t i g a i a a t ig t ta g t g t i a i a a a m a i a a im m t t m t i a t a a am g a i a g g a a t a a a g i a a ita a t a t i a it i it t a a i ag g g a a gi i at a g m ta ga i a a m t t ta i a i ita a a ia i t it i t a i at a tat a a t a a a t a a i t a a g a i mi a a t at m ag a mat ia a ma i ma ag a g at
• 9.
  DoHS, Annual Report2075/76 (2018/19) iii a a a t i i a t m a im m t i m t a ita i i g at a it m t i i a it ta ta a m a i m a i ma at i a t im a t a m t i i t i i t a t mi t i t a mi imi t i a t i a t t a ia t mi a t a t m t a a t i a a am g a i tat m a i m a ma m i i i m t t i t a t i i a a a ag a a at Collaboration and partnerships among governmental, non-governmental and private sectors shall be promoted, managed and regulated in the health sector and private, internal and external investments in health education, services and researches shall be encouraged and protected a t i it i at a g m ta ga i a a a i a am t t a t a t atm t a i i ta g t g a a a i a i m i t i t i a i a a ia t i at t a i t m t a a i a t i a ia i i it a a m t a am t a a ita a a a a a g m ta g m ta i at t imi a i at ita a ag t t i t at ma a a i a mm i g a t m ita a a t i t t i i a ma ma at a m it i g a g a a t i a t a a it a t i t a a t mi i g t a i a i i t atm t a a t i i a a t ita a a t i t a t t i m a m t i g ia i a ia i a t i a t g a t i t t g m ta i at a g m ta t t i m i a t i a m t a ma a t t a m i i a ma ag t g a Ayurveda, naturopathy, Yoga and homeopathy shall be developed and expanded in an integrated way i it t a t t i i t at it i a t a a t ma a a a t a t a t m a ga a at at m at a i a t a a a a t a t t
• 10.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i a a ai a m i i a mi a a a ima ta a i t a m t it m a i i a i a t a a ia a m t i g a t a i a a t a t m a i t ma ag a g at a i a am t a a a ga a a a a ma t it ia i i a a a a a ma ga a at at a ta i t t a t t i m a i i a a g a a a a t a t t a a t i a a m a a i it a ta i a t i t atm t a a a a i t a i a at at t m In order to make health services accessible, effective and qualitative, skilled health human resources shall be developed and expanded according to the size of population, topography and federal structure, hence managing health services a a t ma a tai a i a t t m a g t m a t a t t a a it ag i i t g at a a i m a t a a t ma at a t t a t i a a t i t i i a t a a t i a ta i g m t a t i t a g a a im m t i a g m t a t i t t ma it m a t a a t a t i t ita i a im m t i g m t ita it a ia a t i t a ai a i it a i a t i i a a i a t t at a a i t g at t atm t i a im m t i a i ima t atm t m g i ima a i a t a i i t a a t a at a a a g m g t atm t a a ma i g a i a t i a a ai at t ima ita a a a at a a t i t i a g t a t ma t g ig a i i t ai i g i a t ai i g i a m t a t i a a i a a a ag a m t a g m t a ma t ia i ma i t m a g a it a t i g mi i ita ma ag m t m i a a i a t mi t m a a t a m at a im m t t m t a a i a t i a a mi t t a i g i t i t a im m t t g t t t
• 11.
  DoHS, Annual Report2075/76 (2018/19) x x x a a a t i ma t g i m ta a t i t a ma a a t a mai tai a at Structures of Health Professional Councils shall be developed, expanded and improved to make health services provided by individuals and institutions effective, accountable and qualitative i t g at m a a t a t at i a i a im m t a a t t tat t a a t i a a a it a t at i a i a t a t ma t i i i a a a ta t t a t ia i ma a a a i a a a g t ma t a t i a i t t i a i Domestic production of quality drugs and technological health materials shall be promoted and their access and proper utilisation shall be ensured through regulation and management of efficient production, supply, storage and distribution a i m a a t a t t t t mi i a a it g i m t a t gi a a t mat ia a t g at t m i i a ita a ma i it i t i ia a im m t a a a g a t gi a a t mat ia a ag a ia a i a i i a it m ma ag m t i i i a t at t a at i i t a t i i t ia m t at t tat a t it i a g a it a i t i a a ta a m a a im t g a m i a i a a t t i a it m t t a ta a it t ag a i t i t m a ma m a t ma a i g i a g a m i a i i i a ta a a t i a i m i i i m t m i a i a t m i t a a a a a a g m t g m t a i at a a m i a i a a t t a a ma t ma ag im t a t g i a a a a t gt t a a mi ia i ta a a t m a a a i i i a it i t ag i t a t g a a t i a t a it i m i i a a t
• 12.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i Integrated preparedness and response measures shall be adopted to combat communicable diseases, insect-borne and animal-borne diseases, problems related with climate change, other diseases, epidemics and disasters g amm a im m t t a i a t imi a a a i a mm i a i a i i g t i a ma a ia a t m a i i a a a im m t a a it a m a i m a at a tat a a t g a a t imi at a a i at i a a t t a a a t g a i m t a a t i t gi a ag tat a a a ma i ma ag m t g a a m it i g a t a m i a ga ag ita a t i t a a at i i a a a a a t m t m a mm it a t ma ag m t a i m t a i g amm t mi imi imat a g i a t m a i a i a a a i a it ta a i m a t at a t imm iat a i a t a i mi t i a a it m t a a a m i ita i a a a g i a mm it a i a a t i i a a t i i i g i i a t ma ag m t i a a t m a ag Individuals, families, societies and concerned agencies shall be made responsible for prevention and control of non-communicable diseases and integrated health system shall be developed and expanded g amm t m t a t i t a a t t g a t i t a t a i a it i t at it i i g at i m ta a i it a a a t gt t m t a t t a a t i a im m t a a ta a a a im m t t a t a i a m t i a t ma a a a t t m a t t a t at ita i a a a ma it m t at a a m t ma a t a i ag a a a mi a i a t a i g t t ag i g a a a t a g at m a g g a a a i ag t g m t a
• 13.
  DoHS, Annual Report2075/76 (2018/19) ii a a a t i i a a a a a t a t a g at m a g amm a t t a a a g m t a im m t t t a a i t a t i a t ig t i g t i t i a a a a it ta a t a i a t t m t a t i t a t a t i m ta a m t i a t In order to improve nutritional situation, adulterated and harmful foods shall be discouraged and promotion, production, use and access to qualitative and healthy foods shall be expanded t a t i i a g amm i i g it a at a im m t it i it t im mi t i t it a m i a i t ag g i i a a a a i t a m a i a t t m m i m t m a g t m m a at a a a t a t g amm a t i a g amm a t gt a im m t m t i a a t it m a m t a m a ag Health researches shall be made of international standards and the findings and facts of such reports shall be effectively used in policy formulation, planning and health system development t a t t a a it a a a t a i a at a a t a t t a ma a i t a a ta a a a it a a i a t a a a t a a t i a ma a m at t a i i a it a a mi a a a i t t a t a t a t a a i t g at a t a t t a i a i m a i i a a a a t t m m t a a i B g i i ig m i i a mi a a ima ta a a t a i a a t a a a a t t a m t a i t t a t The health management information system shall be made modern, qualitative and technology-friendly and integrated health information system shall be developed a t ma ag m t i ma t m a a a t t a a ma ag i a i t g at ma
• 14.
  DoHS, Annual Report2075/76 (2018/19) iii a a a t i a t ma ag m t i ma t m a ma i t g at t g i t m a a g a a a a it a a a t t i ma a t a i ma tai m a t ma ag m t i ma t m a a i a a i m it i g a a i m a g amm m t a i i ma i g at a i it a t i ma a a a t i ma ia i a mai tai i i g t m i g i a t m i t a t t a t gt a a i t g at i a t m a a im m t Right to information related to health and right of a beneficiary to know about the treatment shall be ensured i i a ma i i a t i ma a t i t a a i ma i a t ig t ia i t i m t i a a i ma a mm i a mat ia t at ma i t i i t a a t a t a i t a i ag a g at Mental health, oral, eye, ENT (ear, nose and throat) health services shall be developed and expanded ima t atm t a i t g at i t a i a t i a t i a a a it i i at a t i a a a t it a t i t a i i t a t i a a t i a g a a a t i a t a t atm t ta i a a a a at a i i g a i a t t a t at t atm t i a a a t a a t m ta a t a ia i a t g ima ita m g t a g a i i i t i a ia t ai i g t ia i a t i a a a a Quality of health services provided by all health institutions including hospitals shall be ensured t a it a t i a g at m a i m a ita t a ta i a at t a i im m i ta a a t i t a a a
• 15.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i im m t a a am m t i i a it ta a a ta a t atm t t atm t t a a am t i i a it a t i a it t g g i i a t mat ia i i g a i m i i m i a i m t i gi a ag t a a t t m t i t i a at a im m t i a a ma ag ia a it a t i t a a i t a t a it i a i t a a a it a t gt a ta a ma ag m t a t i t at a ia a a a im m t Good governance and improvement shall be ensured in policy-related, institutional and managerial structures in the health sector through timely amendments a t g a a a im m t t ma a t i t a a t a ta a i a m a i m a a t a g i a m ai t a gg ia i i i i g a a am a im m t t it a t i i i g i i i a a i t t g at m it i g a a a am a at a im m t t a t a t i a ma ag m t a t i t a i a i g a ia a it a a a g a t t a t i i a a t i t t a a a it a im ma ag m t a t i at a i mm it t t a t i a ma ia i a m ig t a In accordance with the concept of health across the lifecycle, health services around safe motherhood, child health, adolescence and reproductive health, adult and senior citizen shall be developed and expanded a m t a a t i a ma g a it a a a a i a t i ta g t t a ag g a mat a i a t a t i a t a t a t a t a t a g iat i a t a t gt a i a mi i a i g i a a
• 16.
  DoHS, Annual Report2075/76 (2018/19) a a a t i i ia t mi a t t at a t m a t ia g amm a im m t i i a it ta t t gt a m t a a t i i t a a t a a a g i a a i a ma a ita a a t a a t i at it i it a g a a t t t tat Necessary financial resources and special fund shall be arranged for sustainable development of the health sector t g at a t a t at g a m at a im m t t ita a a t a t i t t t it a t a t m i i a ia i t a t t i a t ma tat it a t a g a a i a a t it i i i a a a a a t a t it a a a tai a i m it i t i a i t a t t a a a i a i t a a i i g amm a a a im m g at m t a a a t a i i a t m g amm mi t i m i t a a m t a t a m i i a t i it a it a i a i a a i i t a t a a a g a ia m t a a ma gi a i mm i tat a a g m t a a m am t i t a t t a i i a i t g at a i a t m i i Urbanisation, internal and external migration shall be managed and public health problems associated with such phenomena shall be resolved m g a i i ma a a a t a a a m t t m at t a t g amm t m t ami t a at a a i it t ita gi t a t m t a a i t a mig a a a i a a ma ag a t mi imi t t m a i i a t a a t i i a a a im m t t a t it i g i g ig m m t Demographic statistics shall be managed, researched and analysed to link them with the policy decisions and programme designing
• 17.
  DoHS, Annual Report2075/76 (2018/19) i a a a t i t a m g a i ata it ag i t i a at t g t a a t i t a ta g t a t g amm a ig ag i g Ba t t a t a t i m g a i ata ma ag m t a a a a a t i it t i i ma i g a g amm ig i g t a a i a a it i a i it t a t i i a i it i t t a m a i m a at a i a a ma it ag i t ta i i i a t it i i at a t i Antimicrobial resistance shall be reduced, one-door health policy shall be developed and expanded for the control and management of communicable diseases, environmental pollution such as air pollution, sound pollution and water pollution shall be scientifically regulated and controlled t i a a g amm a a im m t i a t i it a t i t mi imi a t i m ta i i g ai at a mi a i a t a a a a im m t t g at a t a a t a t a mi ia i ta a a a a a im m t t g at a t t mi a i Necessary arrangements shall be made to reduce the risks of immigration process on public health and to provide health protection to Nepalese staying abroad. a a a g m t a ma t a t i a t a t t a t t m t a t a a t i a m a i m a a a t m t a a t a a t i a a a a t ami a ig a a t i g a a ma m ig a a t a ag m t ma t m a a im m t t ma ag t mig a a t i ma 7. Institutional Arrangement i g a a g m t a ma t im m ta t i a a a t i i i a mai a a g i i g i t tat a a g m t t t i i i it i t i ma at a a t a i a i
• 18.
  DoHS, Annual Report2075/76 (2018/19) ii a a a t i im m ta t i i t t t t a t i t i a tat a a a t a t at i t a i im i a m t i a g i i i a t t t g a ta a g i i a t a a im m t a i i t i i t a a a it a t gt a g a ta t a t a t t i g t m i i i i t a t t a a am a t ma m i t at gi a tat a a a a a t t i a t i a a a t i tai a a t i i a a a im m t 8. Financial Resources m t g t a at a tat a a ig a a g a t i tm t m i at a g m ta t a t a ia t im m t t i i 9. Monitoring and Evaluation iat m a i m a ma ag a i t g a m it a a at t a t g amm im m t at a i t tat t a m it i g a a a am a t a a a i g mmi i a t m it i g a a a t m t i i t a ai a a mi i t a a ta i t a t i i g a m it i g a a a t m t i i a t ma ag m t i ma t m a at m it i g a a a t m a ma a i a g a it t t i t m 10. Risks t g t i a a a t i a m at a t t t at g a a t a i a t i a i a a am ta ig t a t i a g amm t m t a t at i i ita a t a it a t i t g t a t t a ai a i it a at g t ma i t i t im m ta t i i a t at gi a t i ma a t t m i a iat it t m t a t i a t t ga i a a m a t ma ag m t a t ma 11. Repeal and Saving a a a t i a a i g t m i i i a t t a a t ma t at gi a m at